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Occupational Therapy Evaluation, Low Complexity

Montana rates for HCPCS 97165

An occupational therapist assesses how a health condition, injury, or developmental issue affects a person's ability to manage everyday tasks like dressing, bathing, or working, then puts together a plan of care. This version applies to more straightforward cases, where the health history and the number of affected daily activities are relatively limited.

Rates data updated July 2026.

Facilitymedian $166 · 10th–90th $89$1910%20%40%10th90th$166Professionalmedian $110 · 10th–90th $72$3160%20%10th90th$110$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$147.91
Median
$147.91
Typical High
$147.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$93.33
Typical High
$380.19
BCBS
Setting
Facility
Modifier
Global
Typical Low
$64,565.42
Median
$75,857.76
Typical High
$91,201.08
BCBS
Setting
Professional
Modifier
Global
Typical Low
$158.49
Median
$158.49
Typical High
$158.49
Cigna
Setting
Facility
Modifier
Global
Typical Low
$134.90
Median
$158.49
Typical High
$190.55
Cigna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$112.20
Typical High
$158.49
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$181.97
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$173.78
Typical High
$181.97
Providence
Setting
Facility
Modifier
Global
Typical Low
$50.12
Median
$89.13
Typical High
$190.55
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$104.71
Typical High
$190.55
United
Setting
Facility
Modifier
Global
Typical Low
$114.82
Median
$114.82
Typical High
$114.82
United
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$93.33
Typical High
$131.83